HomeMy Public PortalAbout5226 CAMELLIA AVE_Electrical__ 004"A 3." APPLICATION FOR ELECTRIC PERMIT
DEi.DA
DIMON OF BUILDING AND SAFETY
i � Of �An„�� f:EUD.,,WM.J. FO COUNTY NQiCNExg DRESSCASSATT D.GRIFFIN.SUPT or BUMMING
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-NUMBSR SACH FSE p
OWNER
LIGHT OUTLETS
R ECSPTAC LF_S MAILS
ADDREHb
WALL.SWITCHES a
TOTAL OuTLST9 - f a
ELSC.RANGES se ELECTRICIAN
EL.SC. HHATERB26 ADDRESS
KW SA CITY TlKL_NO.
FIXTURES LICENSE NO. '
NUMBER OF LIGHT CIRCUITS - DISTRICT O. GRYP Z
NUMBgff a><Aor rot Iasracrlo■
ER OF RECEPTACLE CIRCUITS
MOTORS
NUMB" HORaSPOWER F"EE nSP=ON BECOBD
Nt,Y 1(Vq. HP 0-a-m ING.. a.ACH 5 "
a Lam .s6
BO
II B 1.00
6
15 1 1.00
16 -BO 2.150
BO II00 '41.00
MI
NO.SIGNS
NO SIGNSIGN$ NO PS
FOR MACH
WIRING $1.00
FIXTURES 01,0.0 _
SUPP ENTARY 'Boll A MOVALS
TOT6L FE is DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE TH T I HAVE READ THIS APPLICA ION CONDUIT
AILD STATE THAT THE ABOVE IS CORRECT AND AGREQ TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING' WIRING I
ELECTRICAL WIRIIIG.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AILD/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES �,0URTY AND STATE OF
CALIFORNIA OR THA M THELYGAL OWNER OF THE ABOVE POWER
DESCRIBED IZESID P
BIGNATURE UTILITY CO.NOTIFIED
OF PERMITT
FINAL
WILLIAM J. FOX,COUNrV KNO NSwt VALIDATION A.C.VEIT.CHIQ ELXCT.INSPECTOR
_. 5 9 8 1 t� JUL 2 6 2.9 5 p
M1 - i
76A883-C¢606 3-e9T�` c
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BU'
LDINGDr
DUIL.DINO AND SAFETY DIVISION ADRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO RILL IN CROSS ST. 17
NO. EACH FEE
i f OWNER
RECEIPT._ MAIL
ADDRESS n
LIGHT TOTAL FIRST 20 .20 CITY �J TEL.NO.�87—,Wa
SWITCH OVER 20 .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 APPLICANT
FIXTURES } OVER 20 .10 ADDRESS
RANGE DRYER VTR. HTR. CITY TEL.NO.
STA. COOKDISP. _F.A.U. CONTRACTOR
SPACE HTR_ AIR COND. _ ADDRESS �'��� ry Op
CLOTHES WAS H._DISHWASH. CITY TEL.NO.
FAN_OTHER 1.00 "'to LICENSE NO. CLASS.
MOTORS,TRANSFORMERS RATING I HERESY ACKNOWL[D7[ THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STAT[ THAT THE ABOVE 10 CORRECT AND ASR[[ TO COMPLY
SIZE TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
ELECTRICAL WIRING.
O — 1 1.00 1H[R[SY CERTIFY THAT I AM PROPERLY REGISTERED ND/OR
LI C[N SED AS REWIRED BY LOS ANGEL[■ COUNTY AND STATEOF
1 — 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
R[SID[ IN, THE ABOVE DEL CnIS[D n[l IDEM IAL PROPERTY.
10 - 30 5.00 Ov
SIGNATURE
5o — 100 10.00 OF PERMITTEE Q
100 — 300 15.00 DISTRICT NO. GROUP ZOM[, PnocusE r
TUBE,
SIGN AND ONE CIRCUIT 3.00 ev L Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER goo VOLTS OR 200 ARP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 3.00
TEAS SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DAT[ NOPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (30% PERMIT FEE)
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED Q
SUPPLEMENTARY PERMIT ISSUING FEE 1,00 FINAL r
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. AlH
6 0 4 (TR JLL 2 4- 2 D 5.0 0-
X
SE[ SACK OF APPLICATION FOR COMPLETE F[[ SCHEDULE it